Remember, nothing smaller than your elbow in your ears.....and nose!

A total of 8754 nasal and 17,325 aural foreign bodies have been removed from adults and children over the course of 6 years with a staggering £2,880,148 cost to NHS England. (Hospital Episode Statistics 2010-2016 taken from Department of Health records),

It would seem children are more likely to present to hospital than adults. Of those 8754 nasal foreign bodies, 8353 (95.4%) were in children. Interestingly, the number of procedures in children has not reduced over this study period. And of those 17,325 foreign bodies removed form the ears, children were responsible for 14,875 (85.9%). Putting it into real terms, the removal of all these objects requires 750 hospital bed days a year.

The most common objects requiring removal from noses in children are jewellery items followed by paper and plastic toys. Cotton buds and pencils were most common in ears. Whilst the majority of objects can be removed in the A&E department there are cases that require longer stays in hospital. Children aged 1-4 had the highest number of visits of all groups in this study and were most likely to present with a foreign object in their nose. The 5-9 year olds favoured their ears.

We may all have met someone who had a pea in their ear for years or recall tales of visiting the doctor to have a toy removed from their nose but the dangers are really more serious than we could imagine. Button batteries are not uncommon in children and need to be removed urgently by ENT specialists. Batteries cause an electrochemical reaction with surrounding tissue and do not need to be in situ for very long at all before this reaction starts. Foreign bodies entering the nose can at worst migrate to the upper airways and this too can be potentially life threatening.

The authors of this study believe that foreign bodies are likely to increase over time especially as we see an increase in electronic toys. Small batteries are required for most of these, increasing the dangers. They go on to suggest that stronger legislation may be needed to enforce manufacturers to warn their consumers of these risks and how to recognise when your child has ingested such items.

Read the full study here: 'Will children ever learn? Removal of nasal and aural foreign bodies: a study of hospital episode statistics.' S Morris, MS Osborne, AL McDermott The Royal College of Surgeons.